Maurício Fregonesi Barbosa1,2, Daniéliso Renato Fusco3, Rafael Dezen Gaiolla4, Konrad Werys5, Suzana Erico Tanni6, Rômulo Araújo Fernandes7, Sergio Marrone Ribeiro8, Gilberto Szarf9,10. 1. Department of Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros 800, Vila Clementino, São Paulo, 04024-002, Brazil. maufbarbosa@gmail.com. 2. Department of Tropical Diseases and Diagnostic Imaging, Universidade Estadual Paulista (UNESP), Botucatu, Brazil. maufbarbosa@gmail.com. 3. Cardiology Division, Internal Medicine Department, Universidade Estadual Paulista (UNESP), Botucatu, Brazil. 4. Hematology Division, Internal Medicine Department, Universidade Estadual Paulista (UNESP), Botucatu, Brazil. 5. University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, Oxford, UK. 6. Pneumology Division, Internal Medicine Department, Universidade Estadual Paulista (UNESP), Botucatu, Brazil. 7. Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente, Brazil. 8. Department of Tropical Diseases and Diagnostic Imaging, Universidade Estadual Paulista (UNESP), Botucatu, Brazil. 9. Department of Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros 800, Vila Clementino, São Paulo, 04024-002, Brazil. 10. Hospital Israelita Albert Einstein, São Paulo, Brazil.
Abstract
BACKGROUND: The use of anthracycline-based chemotherapy is associated with the development of heart failure, even years after the end of treatment. Early detection of cardiac dysfunction could identify a high-risk subset of survivors who would eventually benefit from early intervention. Cardiac magnetic resonance feature-tracking (CMR-FT) analysis offers a practical and rapid method to calculate systolic and diastolic strains from routinely acquired cine images. While early changes in systolic function have been described, less data are available about late effects of chemotherapy in diastolic parameters by CMR-FT. The main goal of this study was to determine whether left ventricular (LV) early diastolic strain rates (GDSR-E) by CMR-FT are impaired in long-term adult survivors of non-Hodgkin lymphoma (NHL). Our secondary objective was to analyze associations between GDSR-E with cumulative anthracycline dose, systolic function parameters and myocardial tissue characteristics. METHODS: This is a single center cross-sectional observational study of asymptomatic patients in remission of NHL who previously received anthracycline therapy. All participants underwent their CMR examination on a 3.0-T scanner, including cines, T2 mapping, T1 mapping and late gadolinium enhancement imaging. Derived myocardial extracellular volume fraction was obtained from pre- and post-contrast T1 maps. CMR-FT analysis was performed using Trufi Strain software. The data obtained were compared between anthracycline group and volunteers without cardiovascular disease or neoplasia. RESULTS: A total of 18 adult survivors of NHL, 14 (77.8%) males, at mean age of 57.6 (± 14.7) years-old, were studied 88.2 (± 52.1) months after exposure to anthracycline therapy (median 400 mg/m2). Compared with controls, anthracycline group showed impaired LV global early diastolic circumferential strain rate (GCSR-E) [53.5%/s ± 19.3 vs 72.2%/s ± 26.7, p = 0.022], early diastolic longitudinal strain rate (GLSR-E) [40.4%/s ± 13.0 vs 55.9%/s ± 17.8, p = 0.006] and early diastolic radial strain rate (GRSR-E) [- 114.4%/s ± 37.1 vs - 170.5%/s ± 48.0, p < 0.001]. Impaired LV GCSR-E, GLSR-E and GRSR-E correlated with increased anthracycline dose and decreased systolic function. There were no correlations between GDSR-E and myocardial tissue characteristics. CONCLUSIONS: Left ventricular early diastolic strain rates by CMR-FT are impaired late after anthracycline chemotherapy in adult survivors of non-Hodgkin lymphoma.
BACKGROUND: The use of anthracycline-based chemotherapy is associated with the development of heart failure, even years after the end of treatment. Early detection of cardiac dysfunction could identify a high-risk subset of survivors who would eventually benefit from early intervention. Cardiac magnetic resonance feature-tracking (CMR-FT) analysis offers a practical and rapid method to calculate systolic and diastolic strains from routinely acquired cine images. While early changes in systolic function have been described, less data are available about late effects of chemotherapy in diastolic parameters by CMR-FT. The main goal of this study was to determine whether left ventricular (LV) early diastolic strain rates (GDSR-E) by CMR-FT are impaired in long-term adult survivors of non-Hodgkin lymphoma (NHL). Our secondary objective was to analyze associations between GDSR-E with cumulative anthracycline dose, systolic function parameters and myocardial tissue characteristics. METHODS: This is a single center cross-sectional observational study of asymptomatic patients in remission of NHL who previously received anthracycline therapy. All participants underwent their CMR examination on a 3.0-T scanner, including cines, T2 mapping, T1 mapping and late gadolinium enhancement imaging. Derived myocardial extracellular volume fraction was obtained from pre- and post-contrast T1 maps. CMR-FT analysis was performed using Trufi Strain software. The data obtained were compared between anthracycline group and volunteers without cardiovascular disease or neoplasia. RESULTS: A total of 18 adult survivors of NHL, 14 (77.8%) males, at mean age of 57.6 (± 14.7) years-old, were studied 88.2 (± 52.1) months after exposure to anthracycline therapy (median 400 mg/m2). Compared with controls, anthracycline group showed impaired LV global early diastolic circumferential strain rate (GCSR-E) [53.5%/s ± 19.3 vs 72.2%/s ± 26.7, p = 0.022], early diastolic longitudinal strain rate (GLSR-E) [40.4%/s ± 13.0 vs 55.9%/s ± 17.8, p = 0.006] and early diastolic radial strain rate (GRSR-E) [- 114.4%/s ± 37.1 vs - 170.5%/s ± 48.0, p < 0.001]. Impaired LV GCSR-E, GLSR-E and GRSR-E correlated with increased anthracycline dose and decreased systolic function. There were no correlations between GDSR-E and myocardial tissue characteristics. CONCLUSIONS: Left ventricular early diastolic strain rates by CMR-FT are impaired late after anthracycline chemotherapy in adult survivors of non-Hodgkin lymphoma.
Authors: Juan Carlos Plana; Maurizio Galderisi; Ana Barac; Michael S Ewer; Bonnie Ky; Marielle Scherrer-Crosbie; Javier Ganame; Igal A Sebag; Deborah A Agler; Luigi P Badano; Jose Banchs; Daniela Cardinale; Joseph Carver; Manuel Cerqueira; Jeanne M DeCara; Thor Edvardsen; Scott D Flamm; Thomas Force; Brian P Griffin; Guy Jerusalem; Jennifer E Liu; Andreia Magalhães; Thomas Marwick; Liza Y Sanchez; Rosa Sicari; Hector R Villarraga; Patrizio Lancellotti Journal: Eur Heart J Cardiovasc Imaging Date: 2014-10 Impact factor: 6.875
Authors: Elizabeth C Moser; Evert M Noordijk; Flora E van Leeuwen; Saskia le Cessie; Joke W Baars; José Thomas; Patrice Carde; Jacobus H Meerwaldt; Martine van Glabbeke; Hanneke C Kluin-Nelemans Journal: Blood Date: 2005-12-08 Impact factor: 22.113
Authors: Heloisa Sawaya; Igal A Sebag; Juan Carlos Plana; James L Januzzi; Bonnie Ky; Victor Cohen; Sucheta Gosavi; Joseph R Carver; Susan E Wiegers; Randolph P Martin; Michael H Picard; Robert E Gerszten; Elkan F Halpern; Jonathan Passeri; Irene Kuter; Marielle Scherrer-Crosbie Journal: Am J Cardiol Date: 2011-03-02 Impact factor: 2.778
Authors: András Csaba Nagy; Zsuzsanna Cserép; Edina Tolnay; Tamás Nagykálnai; Tamás Forster Journal: Pathol Oncol Res Date: 2008-03-15 Impact factor: 3.201
Authors: O Hequet; Q H Le; I Moullet; E Pauli; G Salles; D Espinouse; C Dumontet; C Thieblemont; P Arnaud; D Antal; F Bouafia; B Coiffier Journal: J Clin Oncol Date: 2004-05-15 Impact factor: 44.544
Authors: Brandon C Drafts; Katie M Twomley; Ralph D'Agostino; Julia Lawrence; Nancy Avis; Leslie R Ellis; Vinay Thohan; Jennifer Jordan; Susan A Melin; Frank M Torti; William C Little; Craig A Hamilton; W Gregory Hundley Journal: JACC Cardiovasc Imaging Date: 2013-05-01
Authors: Jose Luis Zamorano; Patrizio Lancellotti; Daniel Rodriguez Muñoz; Victor Aboyans; Riccardo Asteggiano; Maurizio Galderisi; Gilbert Habib; Daniel J Lenihan; Gregory Y H Lip; Alexander R Lyon; Teresa Lopez Fernandez; Dania Mohty; Massimo F Piepoli; Juan Tamargo; Adam Torbicki; Thomas M Suter Journal: Eur Heart J Date: 2016-08-26 Impact factor: 29.983